Hi kitty - will be pleased to answer all your questions! I posted on here when I was debating going for Burch's and didn;t come across anyone who'd had the operation (TVT seems to be more common these days) so I am delighted to be able to help 
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The incision was like a slightly shorter and slightly lower c-section incision (although maybe he did mine lower in case I want to have another baby, which I guess won't apply in your case). He did two procedures on me and before I went in he anticipated that the total surgery time would be around 1 hour - so shorter if you're only having Burch's done. Part of the cause of my injuries is that when I gave birth I tore through my urethra. My surgeon did an ultrasound of the urethral sphincter to assess the state of the muscle and the results of this in part determined where the stitches needed to go. If you haven't had this ultrasound it might be worth asking if it is needed, particularly if you might have had any kind of trauma to the urethra.
As you probably know, you will have a suprapubic catheter inserted during surgery. This is a catheter that is inserted surgically through a tiny tiny incision in your abdomen directly into the bladder. They do this so your urethra can just settle down and heal for a few days before having to worry about the mechanics of going for a wee. I was utterly freaked by the idea of this, but the reality was much less grim and I actually really liked having it in. And it was a hell of a lot less uncomfortable than a 'normal' catheter that goes in through the urethra. It was an utter relief to be able to just lie in bed and relax and let them pump me full of loads of saline drip to wash out the anaesthetic without having to worry about getting up for a wee!
After a couple of days they started 'training' my bladder again. This involved disconnecting the urine collection bag, clamping off the tube and getting me to wee into a container every time I went. They would measure the volume I passed and then drain down what remained in my bladder to see how much I was retaining. I think other doctors might use an ultrasound to measure the volume left in the bladder. It was fine. Did this for a couple of days and then when they were happy that things were working OK, I went for 24 hours of weeing as normal and they did a final drain down to see how much I retained in a 24 hour period. They were happy and I had it removed. Again, I was freaked out as all hell, but other than one troublesome stitch that stung a bit, I really didn't feel it. Having a 'normal' catherter out hurts me more. The hole in the bladder and the hole in the skin close on their own very quickly. I did have a small amount of urine leaking inside me which showed up as swelling (sounds really grim I know, but it didn't hurt, urine is sterile and they weren't at all worried once they knew what it was) because the skin hole closed before the bladder hole did, but that went down within a few days. It was literally about 5 mls.
My surgeon said that in about 5% of cases, the catheter needs to be left in for longer and the woman is sent home with it in for a couple of weeks, just to let her bladder heal further. He said that if this happens it is no indication of how successful for the surgery has been and is nothing to worry about.
I was up and about the next day - gentle pottering around the ward. It is a big operation and it does take time to recover from. You will need help at home. It is a bigger deal than TVT and recovery is longer. But if there are good reasons to go for Burch's, I really wouldn't let longer recovery put you off. I have to say that I am much less enthusiastic about my next lot of surgery (rectocele and perineum repair) than I was about this one - personally I'd rather have an incision and stitches (no matter how big) in my abdomen than in my vagina.
I was surprised by how much I could do after the surgery. I though I would be immobile, but I had a full range of movement, just as long as I took things easily and was careful. I felt far more incapacitated after I had my gall bladder out laparascopically when I couldn't even lift my arm without it hurting like all hell.
Monday will be 6 weeks since my surgery. I'm still tired and need a nap every day. It still does hurt, but it's getting less all the time and I don't really need to take painkillers. I'm still swollen, but that is going down too. It'll be another couple of weeks before I'm allowed to lift, push, pull, etc. But then this is true for TVT as well.
I've had 2 check-ups so far and am due another next week. He's been really pleased with the result and says this was definitely the right thing to do in my case. I was so scared and anxious before the operation, but I don't regret it at all.
If you have any other questions, please ask!
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